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One of the women who sued Swanson had been a friend, close enough that she and her husband had one year shared an intimate Valentine's Day dinner at the Swansons' home. The doctor had performed eyelid surgery on the woman's husband, and the procedure had gone so well that she'd ordered a chemical peel for herself a couple of months later.
Swanson had played tennis with the woman's husband at the Indian Hills Country Club. The two couples had danced at Lyric Opera Balls and mingled at society functions. That friendship, however, would not withstand the legal battle.
The patient who died, Ruth Ann Young, had been obese, asthmatic, hypertensive and an insulin-dependent diabetic. She had hoped Swanson could fix her bulging belly.
"She started crying, and she related to me how much of a problem this was for her," Swanson testified in court records. "It wasn't just cosmetic. It was the quality of her life." At first, Swanson was reluctant to operate on the woman. He told her to come back after she'd lost twenty pounds. She returned a few months later, seventeen pounds lighter, carrying a letter from her internist clearing her for surgery.
The three-and-a-half hour surgery at North Kansas City Hospital, which included liposuction and the abdominoplasty, went poorly. After Young developed severe breathing problems, the anesthesiologist called another doctor, Dr. Steve McCray, to the operating room.
"He told me that he had asked Dr. Swanson to stop the operation ... I agreed and said to Dr. Swanson that he needed to stop and quit this foolishness because we couldn't ventilate the patient," McCray testified in depositions.
McCray described Young's abdominal wall as being "tightened to the point where all her intra-abdominal contents were forced into a different location, primarily putting great pressure on her heart and diaphragm and lungs." He testified that, in the recovery room, he had told Swanson to go back to the operating room and reverse the stomach operation, but that Swanson told him, "I am not going to do it. I am going to my office."
After Swanson left the hospital, McCray said, Young entered the intensive-care unit, where "she continued to ooze a significant amount of blood. She continued to remain acidotic. And she -- her blood pressure was not adequate. Multiple times the ICU nurses tried to call Dr. Swanson, and multiple times the house supervisor tried to call Dr. Swanson, and I tried to call Dr. Swanson. And his office nurse said that she had notified him but that he wasn't coming until he got his office taken care of."
Swanson returned later, operated again on Young's stomach and returned her to the intensive-care unit. Swanson was so concerned that he stayed overnight at the hospital. The next day, several of Young's organs failed, and she died. Swanson's insurance company settled the resulting lawsuit out of court, paying Young's relative $550,000, according to court records.
(At a later hearing prompted by complaints to the Missouri medical board, however, McCray's testimony would not be heard. The board's attorney failed to notarize McCray's affidavit, leading a judge to rule it inadmissible. In transcripts of that same hearing, however, Swanson remembered the operation much differently. "During surgery, I overheard the anesthetist talking about her ventilatory pressures, that they'd gone up during surgery," he said. "When I was doing the abdominal repair of the muscles, I asked, 'Did my [first operation] do anything to increase those pressures, and I was told no.")